Manifestations of Chronic Disease During Pregnancy

Kaaja, Risto

doi:10.1001/jama.294.21.2751

Cited by 319 publications

(232 citation statements)

References 113 publications

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“…However, results here presented regarding similarity of risk profiles and current knowledge on similar metabolic, vascular and immune abnormalities support the concept of a common soil of causality for these two diseases. Increased insulin resistance, a characteristic of gestational diabetes (27), has also been associated with the development of preeclampsia (28)(29)(30). Similarly, abnormal endothelial function with impaired flow mediated dilatation (31)(32)(33) and inflammatory cytokine release as C-reactive protein and E-selectin are reported in both conditions (34)(35)(36)(37)(38).…”

Section: Discussionmentioning

confidence: 99%

Gestational diabetes and pre-eclampsia: common antecedents?

Wendland

Duncan

Belizán

et al. 2008

Arq Bras Endocrinol Metab

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Objetivo: Avaliar a concordância do padrão de fatores de risco de mulheres que desenvolvem diabetes gestacional e pré-eclâmpsia. Métodos: Estudo de coorte prospectivo em clínicas de atendimento pré-natal do Sistema Único de Saúde de seis capitais do Brasil, 4.766 mulheres grávidas de 20 a 48 anos de idade foram arroladas de maneira consecutiva entre a 20º e 28º semanas de gestação. O hábito de fumar e os fatores de risco tradicionais para pré-eclâmp-sia e diabetes gestacional foram obtidos por entrevista no arrolamento. diabetes gestacional foi diagnosticada usando um teste oral de tolerância a glicose com 75 g e pré-eclâmpsia por meio de revisão de prontuário. Resultados: diabetes gestacional e pré-eclâmpsia são associadas com idade (rc 2,07; 95% Ic 1,65-2,23 e rc 1,55; 95% Ic 1,08-2,23, respectivamente), índice de massa corporal pré-gestacional (rc 1,62; 95% Ic 1,40-3,53 e rc 1,83; 95% Ic 1,52-4,80, respectivamente) e ganho de peso precocemente durante a gestação (rc 1,28; 95% Ic 1,12-1,47 e rc 1,27; 95% Ic 1,06-1,52, respectivamente).

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Section: Discussionmentioning

confidence: 99%

Gestational diabetes and pre-eclampsia: common antecedents?

Wendland

Duncan

Belizán

et al. 2008

Arq Bras Endocrinol Metab

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“…However, many important prenatal risk factors that impact on offspring development in utero are influenced by maternal characteristics (3)(4)(5)(6)(7). Consider the example of smoking in pregnancy, which is associated with a number of adverse outcomes in offspring including reduced birth weight and increased antisocial behavior.…”

mentioning

confidence: 99%

Disentangling prenatal and inherited influences in humans with an experimental design

Rice

Harold

Boivin

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

124

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Exposure to adversity in utero at a sensitive period of development can bring about physiological, structural, and metabolic changes in the fetus that affect later development and behavior. However, the link between prenatal environment and offspring outcomes could also arise and confound because of the relation between maternal and offspring genomes. As human studies cannot randomly assign offspring to prenatal conditions, it is difficult to test whether in utero events have true causal effects on offspring outcomes. We used an unusual approach to overcome this difficulty whereby pregnant mothers are either biologically unrelated or related to their child as a result of in vitro fertilization (IVF). In this sample, prenatal smoking reduces offspring birth weight in both unrelated and related offspring, consistent with effects arising through prenatal mechanisms independent of the relation between the maternal and offspring genomes. In contrast, the association between prenatal smoking and offspring antisocial behavior depended on inherited factors because association was only present in related mothers and offspring. The results demonstrate that this unusual prenatal cross-fostering design is feasible and informative for disentangling inherited and prenatal effects on human health and behavior. Disentangling these different effects is invaluable for pinpointing markers of prenatal adversity that have a causal effect on offspring outcomes. The origins of behavior and many common complex disorders may begin in early life, therefore this experimental design could pave the way for identifying prenatal factors that affect behavior in future generations.child ͉ psychopathology ͉ genetic ͉ antisocial behavior ͉ birth weight

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“…Con relación al comportamiento de la presión arterial, es importante aclarar que el embarazo es una condición fisiológica saludable, pero en determinadas situaciones puede existir un cierto riesgo de hipertensión para la mujer gestante 38 . Esta lleva consigo otra serie de complicaciones, como puede ser la preeclampsia, muy peligrosa ya que es la responsable del 22% de las muertes maternas 39 y del 18% de las de los partos prematuros [40][41][42][43] ; además, incrementa el riesgo de futuras enfermedades cardiovasculares 44,45 .…”

Section: Discussionunclassified

Efectos de un programa de ejercicio físico supervisado sobre la estructura cardiaca durante la gestación. Ensayo clínico aleatorizado

Perales¹,

Luaces²,

Moro³

et al. 2012

Progresos de Obstetricia y Ginecología

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Recibido el 11 de julio de 2011; aceptado el 11 de enero de 2012 Accesible en línea el 22 de marzo de 2012 PALABRAS CLAVE Embarazo; Ejercicio físico; Sistema cardiovascularResumen Objetivo: Analizar la seguridad del ejercicio aeróbico para el sistema cardiovascular de las mujeres gestantes y valorar las posibles mejoras cardiovasculares producidas.Sujetos y métodos: Se diseñó un ensayo clínico aleatorizado, no apareado, no enmascarado. El registro de datos se realizó en las semanas 20 y 34 de gestación. En la semana 20, se estudió a 45 gestantes del grupo de ejercicio (GE), de las cuales completaron el estudio 35. Del grupo de control (GC), en la semana 20 participaron 14, y completaron el estudio 9.Resultados: En la semana 20 hubo mejoras en el índice de masa corporal (GE: 25,1 AE 4,3/GC: 27,9 AE 4,5) (p = 0,04) y en la presión arterial sistólica (GE: 104,7 AE 10,9/GC: 112,5 AE 11,3) (p = 0,02). En el GC hubo presencia de hipertrofia concéntrica (n = 2, 14,3%). En la semana 34, el GE presentó un mayor volumen sistólico (GE: 52,33 AE 10,42/GC: 43,69 AE 9,48) (p = 0,03).Conclusión: El ejercicio aeróbico durante el embarazo es seguro para el sistema cardiovascular, mejorando incluso algunos parámetros.

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Manifestations of Chronic Disease During Pregnancy

Cited by 319 publications

References 113 publications

Gestational diabetes and pre-eclampsia: common antecedents?

Gestational diabetes and pre-eclampsia: common antecedents?

Disentangling prenatal and inherited influences in humans with an experimental design

Efectos de un programa de ejercicio físico supervisado sobre la estructura cardiaca durante la gestación. Ensayo clínico aleatorizado

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